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Breast augmentation is one of the most
frequently performed cosmetic procedures in my practice. Women
usually schedule a consultation and want to enhance their
breasts for a number of reasons:
- To correct flattening of their breasts
following pregnancy and breast feeding.
- To enhance curves
and give proportion to a woman who feels her breast size
is too small.
- To balance a difference in breast size.
I like to take into consideration
the woman's body type when discussing the size and type of
the breast implant. Height and body weight are certainly important
elements to consider. The width of the shoulder and the chest
wall has very important barring on how a particular breast
implant will look on a particular woman. The waistline is
critical to the size of the breast implant I recommend. My
goal is to create female curves that are elegant and pleasing,
starting from the armpit, gently curving outwards and then
back into the waistline. A well shaped breast is one that
gives curves to a woman that is balanced with the waist and
hips, without being distracting, uncomfortable and looking
awkward in clothing.
There are a number of different incisions
that can be used:
- Circumareolar. In the lower part of
the nipple areolar complex between the colored portion of
the nipple and normal skin. The incision I use is only 1
inch long.
- Inframammary. Along the breast crease.
I prefer this incision when placing silicone gel implants
(they are pre-filled, requiring a larger incision than the
diameter of the nipple areolar complex), or performing implant
exchange where I have to remove the implant capsule(scar
tissue).
- Transaxillary. Through the arm pit. I prefer to use
the endoscope (a small camera that is inserted in the chest
wall to assist in creating the implant pocket more delicately
and precisely.
- Transumbilical (through the belly button).
For specific indications. Nipple areolar complex too small
or someone who is not a candidate for transaxillary approach.
There are many other issues surrounding
breast augmentation that are important, such as longevity
of the breast implants, health concerns of silicone gel, capsular
contracture, sensitivity, breast feeding, scarring. I like
to have detailed discussions of these issues at the time of
initial consultation, so please feel free to ask questions.
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Santa
Monica Breast Augmentation 
